Functional Medicine Applications: Reversing Eight Vicious Cycles that Block Fibromyalgia and CFS Healing (and also normal healing in many other forms of illness)
People with any chronic illness tend to develop a set of self-defeating vicious cycles, which conventional medical approaches too often overlook. Our office places high priority on reversing these self-defeating cycles, as they are major obstacles to healing.
Vicious Cycle #1: Non-restorative Sleep
Both FMS and CFS disrupt sleep quality. Poor sleep, in turn, worsens physical and mental stamina. Poor sleep also increases sensitivity to pain. These, of course, further disrupt sleep. Dr. Podell’s lecture Improving Sleep Quality Despite Fibromyalgia or Chronic Fatigue Syndrome provides additional information.
Vicious Cycle #2: Disordered Breathing Rhythms
More than half of our patients with FMS or CFS develop a disordered pattern of breathing. They take very small rapid breaths using the small muscles of their chest instead of slow, deep breathing with the large muscles of the abdomen. These changes are subtle and most people who “hyperventilate” in this manner don‘t realize that their breathing pattern is out-of-sync.
Shallow chest breathing makes people feel tense. Slow, deep abdominal breathing creates feelings of calmness. Disordered breathing can also cause a broad array of frightening symptoms including mental fog, dizziness, irritability, chest pain, feeling numb and more. Worse symptoms then disrupts breathing further.
Vicious Cycle #3: Inactivity Leads to Progressive Loss of Physical Fitness (De-conditioning)
People with FMS and CFS feel too ill to exercise, and if they push they get worse. However, not exercising at all is also a mistake. With inactivity, fitness fades. This increases vulnerability (i.e. it takes less and less exertion before you push over your limits). This leads to less activity, which in turn, leads to lower blood pressure and blood volume. Blood sugar becomes unstable. Disruptive stress hormones increase (e.g. adrenalin and cortisone). People feel worse, so they can do even less. And the cycle repeats.
Vicious Cycle #4: Magnesium Loss in the Urine
Both physical pain and mental distress cause magnesium loss through the urine. Low magnesium, in turn, turns up pain volume and also heightens vulnerability to stress. This brings about further magnesium loss.
Vicious Cycle #5: Hormonal Imbalances
Both physical and mental distress trigger the release of hormones such as cortisol that promote tissue breakdown. At the same time, distress depresses the output of hormones that promote growth (e.g. DHEA growth hormone). Thyroid and sex-hormones may also be affected. These hormonal disturbances undermine healing, which then lead to further hormone disruption.
Vicious Cycle #6: Blood Sugar instability
The five vicious cycles just discussed all have adverse effects on the body's blood sugar and insulin system. Blood sugar tends to rise higher after eating carbohydrates, and then fall rapidly lower, the “hypoglycemic” reaction. Actually, low blood sugar per se is not the direct cause of symptoms. Rather, falling blood sugar causes ‘stress hormones’ to surge, including adrenalin and cortisol. These disruptive hormones are actually the cause of most ‘hypoglycemia’ symptoms. These symptoms include: mood instability, depression, light-headedness, foggy brain, fluid retention and fatigue. (See also hypoglycemia symptoms, hypoglycemia treatments)
Vicious Cycle #7: Mind/Body Tension
Feeling bad for so long makes people “tighten up”, both literally in their muscles and figuratively in their mind. Muscle tension increases pain and stiffness. Mental tension creates feelings of anxiety, and a sense of not being in control. This causes more physical and mental tension, reinforcing the illness. This is one reason that people with Fibromyalgia are more likely to suffer from migraine or tension headaches. When headache pain is bad, this also tends to make Fibromyalgia worse.
Vicious Cycle #8: Losing Perspective, Losing Hope
People who are chronically ill tend to lose optimism and also their sense of perspective and proportion. Small set backs feel like catastrophes. Dips feel like forever. Anger suppresses immune function. They may lose hope and stop trying. This heavy burden adds to the illness.
What tools do we have to reverse these vicious cycles?
- For sleep quality, we have many options including behavioral training, nutritional supplements, herbs and medicines.
- For disordered breathing, we teach how to restore rhythmic breathing. This can be mastered in just two or three training sessions.
- To improve physical fitness, the Goldilocks Principle applies – not too much exercise and not too little, but just the right amount. Within a few months this usually improves fitness, function and symptoms.
- For low magnesium, we offer a specialized test of magnesium status, and aggressively replace deficiencies.
- For hormone imbalances, we measure relevant hormones and consider the pros and cons of hormonal supplements.
- We treat blood sugar instability with the traditional anti-hypoglycemia diet plus several important new wrinkles.
- To reduce physical and mental tension, we teach a broad set of practical relaxation skills.
- There are also techniques for regaining perspective and realistic hope without long-term psychotherapy. Cognitive Behavioral Therapy (CBT) is a brief educational technique that teaches you how to ‘reframe’ practical problems so that you deal with them more effectively. More information on this can be found on our Stress Management Techniques and Treatments section.
Our strategy is to reverse first one vicious cycle, then the next and the next. This removes obstacles that perpetuate illness, thereby strengthening the body’s natural abilities to heal.
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